Missouri State Senate


SB 1007 - This act modifies provisions relating to public assistance programs administered by the state.

Current law requires reimbursement for services provided to an individual who is eligible for MO HealthNet, Medicare Part B, and Supplementary Medical Insurance to include payment in full of deductible and coinsurance amounts as determined by federal Medicare Part B provisions. This act exempts MO HealthNet from paying for the Medicare Part B deductible and coinsurance amounts for hospital outpatient services. Section 208.010

This act authorizes the Department of Social Services to require prepaid health plans to limit reimbursements to health care providers who are not contracted providers with the plan to 95 percent of the MO HealthNet rate paid to enrolled providers for services to MO HealthNet participants who are not enrolled in a prepaid health plan. Section 208.166

This act requires both personal care assistance vendors and in-home services providers to use a telephone tracking system to review and certify the accuracy of reports of delivered services and to ensure more accurate billing. The requirements of the telephone tracking system are specified in the act. Vendors and providers with more than 150 consumers must have the system fully operational by July 1, 2011. Vendors and providers with 150 consumers or less must have the system fully operational by July 1, 2012. In order for vendors or provider agencies to obtain an agreement with the Department of Social Services, the vendor or agency must demonstrate the ability to implement the telephone tracking system.

Personal care assistance consumers shall be responsible for approving requests through the telephone tracking system and shall provide the vendor with necessary information to complete the required paperwork for establishing the employer identification number.

This act is substantially similar to provision in HB 1918 (2010).